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04-4435 (BLCK).00o ot _ �- BUILDING & SAFETY DEPARTMENT _P O'.1BOx 1504 (760).777-7012 !cMpF.9 s 78149,5 CALLE TAMPICO FAX (760) 777-7011 ;LA QUJNTA, CALIFORNIAT ALIFORNIA 92253 INSPECTION REQUESTS (760) 777-7153 BUILDING PERMIT Application Number . . . . 04-00004435 Date 5/21/04 Property Address . . . . . . .60507 WHITE SAGE DR APN: 764-270-999-75 -300231- Application description . . . WALL/FENCE Property Zoning . . . . . . . MEDIUM HIGH =NSITY. RES Application valuation 1875 Owner Contractor- SHEA LA QUINTA SHEA HOMES, INC. C/O JEFF MCQUEEN 81260 kVENUE 62 8800 N GAINEY CENTER 350 LA QUI14TA CA 92253 SCOTTSDALE AZ 85258 (760) 777-6005 WCC: NTL UNION INS WC: 7165833 08/01/04 CSLB: 672285 06/30/05 CCC: B ---------------------------------------------------------------------------- Permit . . . . . . WALL/FENCE PERMIT Additional desc Permit Fee . . . . 43.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 1875 Qty Unit Charge Per Extension BASE FEE, 15.00. 14.00 2.0000 HND '-BLDG-501'2, 000 28.00 ----------------------------------------------------------------------------- Special Notes and Comments 72 L.F. 6' GARDEN WALL, ORCO SYSTEM , Fee summary Charged ----------------- Paid Credited Due ----------- Permit Fee Total 43.00 ------------------------------ .00 .00 43.00 Plan Check Total .00 .00 ..00 .00 Grand Total 43.00 .00 .00 43.00 P.O. Box 1504 78-495 CALLE TAMPICO � VOICE (760) 777-7012 LA QUINTA, CALIFORNIA 92253 4 4 aFAX (760) 777-701 1 BUILDING &SAFETY DEPARTMENT INSPECTIONS (760) 777-7153 Application Number: 04 y,� Applicant: Architect or Engineer: . Date: Applicant's Mailing Address: Architect or Engineer's Address: -------------- Lic. No.: BUILDING PERMIT DECLARATIONS LICENSED CONTRACTOR'S DECLARATION I hereby affirm updoo-aenafty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals �Code, and my Uri rr fug force and effect. / / ^ ^ 04�r., Licenset•Cl�as(s . y License No.(�p l a ,---'Date' "` Ib ontractor 1--,_ I hereby affirm under penaltyof OWNER43UILDER DECLARATION perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5, Business and Professions Cade: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for ft permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500).): (--) I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sob.). U I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors, License Law does not apply an owner of property who builds or improves thereon, and who contracts for the projects with a oontractor(s) licensed pursuant to the Contractors' State License Law.).) . U I am exempt under Sec. , BA P.C. for this reason Date Owner I herebyaffirm under WORKERS' COMPENSATION DECLARATION penalty of perjury one of the following declarations: _ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of thework for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issue . y war kers' co abon insu r nb�r artier 1/t � {,ice icy Numbe d(p, O _ I certify that m the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree fiat, if I should be forthwith comply with those provisions. come subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury that there is a construction lending agency forJthe Performa AGENCY Of the work for which this Permit is issued (Sec. 3097, Civ. C.). Lender's Name Lender's Address IMPORTANT Application is hereby made to the Director of BuildingAPPLICANT dANT CKNOWLEDGEMENT Safety a 1. Each person upon whose behalf this application is made, each person at whose request and for hrose benefit work stions and nPerformed under or ps set forth on this ursuant to an issued as a result of this application, the owner, and the applicant, each agrees to, and shall, defend, indemnity and hold harmless the City of La Cluinta, its it officers, agents and employees for any act or omission related to the work being performed under or following issuance of this permit. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 day* from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information ' correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this cou nter u n above�nentioned property for inspection purposes. /D at�Li�,'Sig­nature (Applicant or A ernt� 9 )